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Susan Ivy
Susan Ivy, Nurse (RN)
Category: Health
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Experience:  BSN, MSN, CNS
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I have schizoaffective disorder. my question is, Is having

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I have schizoaffective disorder. my question is, Is having nightmare normal with this disorder?
I am a 27 year old male that diagnosed with schizo affective disorder. Lately I am having nightmares every night they are very severe and distressing I wake up with fast heart beat as I think I am having a heart attack and with sweating as well. Because of this nightmare my whole day is a disaster can't think clearly I just wonder with blank mind. So is this normal with schizo affective disorder patients?
I am on antidepressants 300 mg effexor it is been almost 2 weeks but no effect does it take longer than two weeks to respond well? thank you
Hello and thank you for using JustAnswer Health.

It is normal to occasionally have a nightmare, but not normal to have a night mare frequently and certainly not every night.

When did the nightmares start? Before or after you started the Effexor? Have they improved or worsened in the last 2 weeks since you have been taking the Effexor?

As far as the effects of Effexor, very slight effects can be felt after a few days, by two weeks some effect will usually be noticed. The full effects can take 3 months to a year, although usually by 1 to 3 months you will note improvement.

There are certain instances where people do not respond well to Effexor. I can not say that this is true in your case without more information, and this is why it would be helpful to at least know when your nightmares started, and whether they have improved or worsened since you started the Effexor.

I'll be standing by to receive a reply from you.
Are you there? When did your nightmares begin?
Customer: replied 4 years ago.

Hi Did you got my message?

No I have not received any message from you, just this last statement "Hi did you get my message"
Customer: replied 4 years ago.

Sorry about that. I forgot to mention it earlier I also have PTSD, but the nightmares are not about my PTSD experience. They are completely different they are very intense and bad some of them are very disgusting as well. I am also on Resperidone 2 mg then doctor increase the dose to 4 mg still no difference. She said she is hoping that resperidone help me but I am very frustrated. I also heard Effexor sometimes make depression worse or increase suicidal thought which this happening to me sometimes.

And yes I had nightmares before taking 300 mg of effexor. Thank you Susan

Thank you for the reply.

So it sounds like the nightmares have been present for a while. But are they worse since taking Effexor?

Effexor works on two neurotransmitters, seretonin, which is usually calming, and norepinephrine. The norepinephrine component, can be 'activating' which means it can give more energy. But, in some people rather than just improved energy levels, the norepinephrine neurotransmitter may result in symptoms such as anxiety, difficulty sleeping, irritability, more rapid thoughts, and even mania in some people.

Increased thoughts of suicide can occur with most types of antidepressant.

No mater what the cause, if you are having increased thoughts of suicide, then the situation needs to be examined very carefully.

Can you tell me how long has it been since your Risperidone was increased?

Also, how is your sleep? Are you sleeping more hours or less hours since the Effexor was started? Even better, how many hours were you sleeping before you started it, and now that you have been on it for two weeks, if you can remember.
Customer: replied 4 years ago.

Hi again Susan,

Yes, they are worse since taking high dose of effexor. Though I had worst nightmares but now it is beyond worst.

It is been a week I am on 4 mg of Risperidone as I said before no effects whats so ever. I have an appointment with my psychiatrist soon and I know either she will increase the dose or change to something else or get upset.

At first my sleep was really bad, then they putted me on serouquel and my sleep got better now I stopped seroquel I am back to square one so yes my sleep is not good. Effexor made it worse.

I was sleeping around 6 hours now I sleep for like 3 or 4 hours.

Thank you,


Ok, thanks for getting back to me.

This is serious, and I think that it is important that you call your doctor and do not wait until your next appointment. You can tell your doctor that you spoke to a Psychiatric Clinical Nurse Specialist who advised you to do so. Your doctor should never get mad at you, and even if they do sound a bit irritated at first from getting a call from you, trust me, they would much rather get a call from you than to have to go see you because you are in the hospital or something even worse than that has happened.

It is extremely significant that you are only getting 3 to 4 hours a sleep and that you have increased Suicidal thoughts.

I do not think that the Effexor is helping you at this point. It is possible the doctor will keep you on it, but at this point it sounds like it either needs to be stopped, or you will need to have another drug like a mood stabilizer started (I'm not suggesting that... but I am certain something must be changed before your situation gets even worse)

Here is what you need to tell your doctor:

-you have gone from 6 to now 3 to 4 hours of sleep,

-your nightmares are worse

-you have difficulty coping during the day and your mind goes blank

-you are having increased suicidal thoughts.

It is actually great that you are reaching out. It is obvious that you are trying to do the right thing and follow your doctor's orders. Your doctor should be proud of you.

You should call now before it gets too late. Your doctor should have an answering service that can get in touch with them, if they don't answer themselves.

If not, you may need to go to an emergency room, such as a psych emergency room.

Let me know what you decide to do and how it goes. I'll be here to guide you along if you have any questions about anything. (if I don't get back immediately, it will just be in 30 min at the most)
Customer: replied 4 years ago.

Thank you so much Susan for your help. You are one big psychiatrist I should say. I will call in tomorrow to see if I go as a walk-in. Other wise if I feel suicidal or restless I will go to ER. I live in Canada and to be honest our medical care is not that great. My health is very important to me and this time if I feel my psychiatrist is not helpful or just giving me punch of medication I will come to USA for a second opinion about my condition

Susan, do you know when resperidone should respond well? should I give it more time? Thanks a bunch

You are such a nice person!

The Risperidone should begin to help within at least a week or two, but the full benefit can take 6 to 12 weeks.

Yes, if you cannot sleep or feel suicidal please do go to ER at least.

And you may be luckier than you think about your health care. Here, there is only care if you have money or a very good job that pays for it, and yet there are still waits, even then. Things are not like they were in the past, with Health care in the u.s., thus the reasons it is going through a big overhaul. But that is certainly a different subject.

Please do take care, and update me if you like.
Susan Ivy and 2 other Health Specialists are ready to help you
Customer: replied 4 years ago.

I will for sure update you and again thanks alot. I wish you a very happy new year. Happy 2013.

Customer: replied 4 years ago.

Hi Susan,

Happy New Year. I went to my psychiatrist explained her everything she said I have to be on effexor a little more longer. She prescribed me APO-Lorazepam 2mg for sleep and anxiety. She increased Resperidone to 6mg still no effect she said she will switch it to something else. Now Effexor lessen my depression very little bit not that much I guess it takes more time every

Customer: replied 4 years ago.

Hi Susan,

Happy New Year. Sorry my other message disappear because of technical problems. So I went to my psychiatrist explained her everything. She said I have to be on Effexor a little more longer. She prescribed me APO-Lorazapam 2mg for sleep and Anxiety. She increased Resperidone dose to 6mg still no help she said she will switch it to something else. Effexor lessen my depression very little I guess I need more time to fully see the results everyone is different.

Susan, Because I was in a car accident and extreme pain. Then my fiance called off the wedding so I went under alot of stress. Can high stress trigger Schizophrenia? My psychologist told me I have schizophrenia. But I don't know what cuase it stress or car accident? I thank you for your help.